Doctors left in limbo as Medical Council of Canada cancels controversial exam

VANCOUVER -

At a time when Canada continues to deal with a shortage of doctors, many residents say they have not been able to become fully licensed since the pandemic began.

“As residents, we are the ones who are working 100-hour weeks, we are the ones who are working all night long, we are the ones who are dealing with the COVID patients,” said Dr. Salpy Kelian, third-year resident in internal medicine at the University of British Columbia.

Dr. Kelian told CTV News her career has been stalled by a controversial medical exam, which has cost her $3,000, only be cancelled three times by the Licentiate of the Medical Council of Canada (LMCC).

“We’re stuck in limbo – a lot of people have missed out on job opportunities and are having trouble trying to find someone who is going to supervise them,” added Dr. Kelian.

Physicians who chose internal medicine as their speciality typically work three years as a resident doctor, before becoming a fully licensed doctor and "clinical associate" in their third year of residency.

In order to gain those qualifications, Dr. Kelian had to write the MCC Qualifying Examination Part II, or MCCQE II.

“You get more money once you pass this exam. You get more responsibility, and you need this exam to practice as a physician as well,” added Dr. Kelian.

Dr. Kelian said it has been difficult to maintain good patient care throughout the pandemic.

“We are struggling to maintain our normal coverage – given the fact we no longer have as many CAs available,” added Dr. Kelian.

The LMCC officially scrapped the medical licensing exam on May 31, after technical difficulties prevented candidates from completing the test.

“Not only were there technical problems but the standardized patients weren’t able to connect to the virtual meeting. Some examiners didn’t even show up,” added Dr. Kelian.

Last year, the LMCC cancelled in-person sittings in the spring and fall on short notice due to pandemic concerns.

Many resident doctors have prepared for the exam multiple times over the past year and have lost time and money due to the last-minute cancellations. Meanwhile, their careers have hung in limbo.

Family physician in Terrace, B.C., Dr. Patrick Hemmons described a similar story, saying he spent hours preparing and taking unpaid leave.

“I also can’t see why this wouldn’t impact patient care. I kept taking time away from my patients to study for this exam only for it to be cancelled last minute,” said Dr. Hemmons.

In an email to CTV News, LMCC said on June 9 it defined the criteria that would be considered to grant candidates the Licentiate of the Medical Council of Canada, required for full licensure in most provinces and territories.

MCC’s website also states that it is working collaboratively with the Medical Regulatory Authorities (MRAs) to determine a process such that qualified candidates currently on provisional licences can be granted full licenses by the MRAs.

Dr. Hemmons said it has been one year since he graduated residency. Since then he has been working under a provisional licence, preventing him from becoming a fully licensed doctor.

He adds the latest statement from LMCC still leaves many questions unanswered – as he still has not heard back from the College of Physicians and Surgeons of BC.

The College of Physicians and Surgeons of BC did not respond to CTV’s request for comment.

“I’m still under a provisional licence pending the college’s decision I guess, but yeah, we’ll see, hopefully, I don’t know,” added Dr. Hemmons.

The LMCC has maintained the importance of standardized testing of generalist competencies like assessment, diagnosis, and professional behaviour. It also appears the organization is leaving the door open to reintroduce the exam or something like it down the road. According to the LMCC, “criteria for the award of the LMCC may be reviewed at a future date as standardized assessment requirements for physicians evolve.”

“This statement still leaves a lot unexplained. We don’t know how this is going to affect international medical graduates,” said Dr. Hemmons.

Resident doctors have questioned the relevance of the MCCQE II in recent years, many arguing its outdated and not related to their speciality.

“It’s not really relevant to the current structure of medicine,” added Dr. Kelian.

“The exam itself is archaic exam that really serves no purpose – other than making that company a lot of money.”

The LMCC says it will refund exam fees to candidates registered for the latest session within the next 30 days, but it may take up to two months to award them certification under the new rules. For other eligible candidates, the process will require coordination with third parties and may take longer.